Women who were 55 or younger at the time of myocardial infarction (MI) had significantly higher rates of obesity, diabetes, heart failure, kidney failure, and history of stroke (P<0.001 for all comparisons), according to Rachel Dreyer, PhD, of Yale University, and colleagues.

Younger female patients had significantly worse scores on surveys of general health as compared with male MI patients in the same age range (P<0.001). Overall physical function, quality of life, and frequency of angina also were worse among women than men of the same age at the time of MI, they reported at the American Heart Association Quality of Care and Outcomes Research Scientific Sessions in Baltimore.

"Compared with young men, women under 55 years are less likely to have heart attacks, but when they do occur, women are more likely to have more medical problems, poorer physical and mental functioning, more chest pain, and a poorer quality of life in the month leading up to the heart attack," Dreyer said in a statement.

"We need to develop better methods for recognizing and treating young women with chest pain to optimize their quality of life and potentially prevent a heart attack," she added. "General health and disease-specific health status assessments are valuable tools for healthcare providers to measure the burden of disease in patients. These should be standardized into clinical practice, much like assessments for other traditional heart disease risk factors."

Overall rates of MI are similar between men and women, but the age distribution differs substantially. Men tend to have heart attacks at a younger age, but rates among women catch up after menopause.

Nonetheless, some younger women do develop MI. Few studies have examined health-related characteristics of women who have MIs at younger ages. An international research team sought to fill in some of the missing data by conducting a large observational study known as VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients).

Investigators enrolled 2,990 men and women who were 18 to 55 at the time of acute myocardial infarction. As specified by the protocol, women accounted for two-thirds of the patients. Clinical data came from the patients' medical records, and information about health status was obtained during interviews that included three health questionnaires: Seattle Angina Questionnaire (SAQ), Short Form 12 (SF-12), and EuroQol (EQ-5D).

The study population had a median age of 48, which did not differ between the sexes. Clinical data showed that in the month before MI significantly more of the women (P<0.001) were affected by:

The results paint a picture of female MI patients who are sicker than perhaps many cardiologists and other clinicians have recognized, said Sharonne Hayes, MD, of the Mayo Clinic in Rochester, Minn., who was not involved in the study.

"Younger women, compared with younger men, have a much lower rate of heart attack, but when they do have a heart attack they are much more likely to die," Hayes told MedPage Today. "I think the results of this study help us by showing that these women do have risk factors. In fact, they have very significant risk factors compared with men."

"This will help us to focus our prevention efforts and to better recognize these individuals so their outcomes are better," she added.

Dreyer and co-investigators reported no relevant conflicts of interest.

Working from Houston, home to one of the world's largest medical complexes, Charles Bankhead has more than 20 years of experience as a medical writer and editor. His career began as a science and medical writer at an academic medical center. He later spent almost a decade as a writer and editor for Medical World News, one of the leading medical trade magazines of its era. His byline has appeared in medical publications that have included Cardio, Cosmetic Surgery Times, Dermatology Times, Diagnostic Imaging, Family Practice, Journal of the National Cancer Institute, Medscape, Oncology News International, Oncology Times, Ophthalmology Times, Patient Care, Renal and Urology News, The Medical Post, Urology Times, and the International Medical News Group newspapers. He has a BA in journalism and MA in mass communications, both from Texas Tech University.

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